Article Text
Abstract
Background Ireland needs evidence-based strategies for meaningful engagement in ACP activities. This study aimed to identify factors associated with conversations with trusted others among older adults in Ireland. Methods: Data from the Irish Longitudinal Study on Ageing (TILDA), a nationally representative study of community-dwelling older adults (≥50 years old), was used. Participants who consistently reported ACP conversations with trusted others at Waves 4 and 6 (n=2764) were included. Binary logistic regression was carried out using these ACP conversations as a dependent variable (categorised as engagement/nonengagement). The results of a mixed-research synthesis informed selection of explanatory variables; including age, gender, education, pain, making a will, religiosity, wish to die, and marital status. Data were stratified by gender and age groups. Results: Although men (n=1242) were 58% less likely to engage in conversations with trusted others, there was a 4% increase in odds of their engagement per year older. Younger participants (≤64) who made a will were 99% more likely to report ACP conversations. Those who were ≤74 years old and reported pain were 42% more likely to engage. Men and younger participants (50–64) who ever experienced a wish to die were over twice as likely to report ACP. Similarly, men and those >74 years old with a third level education were twice as likely to engage. for every additional score on the health literacy scale, women were 56% more likely to report ACP. Younger participants (50–64) for whom religion was somewhat important were 36% less likely to engage. While single women were 49% less likely to engage, separated, divorced, or widowed women were 43% more likely to report ACP. Conclusion: This study identified theoretically important factors associated with ACP conversations with loved ones in Ireland and highlighted gender and age groups differentials. These findings will inform policy and ACP intervention development.